Partial carinal resection and reconstruction for mediastinal type of lung cancer.

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A 62-year old man was found to have cancer cells by sputum cytology in a medical checkup. A routine chest film was normal, but a computed tomogram of the chest revealed a 3.0 × 2.3 cm lesion in the tracheo-bronchial angle about to invade the right wall of the carina. The CEA level in the blood was 249 ng/ml. An upper lobectomy and a partial resection of the trachea, carina and main-stem bronchus were performed. A pedicled patch graft was judged to be inappropriate for closure of the defect because of a loss of cartilaginous rigidity. Sleeve resection of the main-stem bronchus, and side-to-end tracheo-bronchial anastomosis were performed.<BR>Although the postoperative course was uneventful, the patient was hospitalized 3 months later because of sudden dyspnea.<BR>Bronchoscopy revealed anastomotic stenosis due to granulation tissue, but it was treated successfully by endoscopic Nd-YAG laser. He has remained well to date, and CEA values have been in the normal range.
特定非営利活動法人日本呼吸器外科学会の論文